{extend name="layout/base" /}

{block name="title"}入驻人联系方式 - 商家入驻 - {mall:config name="mall.sitename"/}{__block__}{/block}
{block name="meta"}
{__block__}
<link rel="stylesheet" href="__ADDON__/__STYLE__/css/shopapply.css">
<link rel="stylesheet" href="__CDN__/assets/libs/nice-validator/dist/jquery.validator.css">
<link rel="stylesheet" href="__CDN__/assets/libs/fastadmin-selectpage/selectpage.css">
{/block}

{block name="main"}
<div class='container'>
	<div id="stepflex" class="stepflex">
       <dl class="first doing">
          <dt class="s-num">1</dt>
          <dd class="s-text">签订入驻协议</dd>
          <dd></dd>
       </dl>
       <dl class="normal doing">
          <dt class="s-num">2</dt>
          <dd class="s-text">入驻人联系方式</dd>
          <dd></dd>
       </dl>
       <dl class="normal doing">
          <dt class="s-num">3</dt>
          <dd class="s-text">公司证照信息</dd>
       </dl>
       <dl class="normal doing">
          <dt class="s-num">4</dt>
          <dd class="s-text">财务及基本信息</dd>
       </dl>
       <dl class="normal">
          <dt class="s-num1">5</dt>
          <dd class="s-text1">店铺信息</dd>
       </dl>
       <dl class="last">
          <dt class="s-num1">6</dt>
          <dd class="s-text1">入驻审核</dd>
       </dl>
    </div>
    <div class='mall-clear'></div>
    <div class='main-head'>财务及基本信息</div>
    <div class='apply-box'>
        <form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="/addons/mall/shop/joinStep4">
            {:token()}
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">{:__('Shopcompany')}:</label>
                <div class="col-xs-12 col-sm-8">
                    <input id="c-shopCompany" class="form-control" name="row[shopCompany]" type="text" value="{$apply.shopCompany}">
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">{:__('Areaids')}:</label>
                <div class="col-xs-12 col-sm-8">
                    <input id="c-areaIds" data-rule="required" class="form-control" name="row[areaIds]" type="hidden" value="{$apply.areaIds}">
                    <div class="col-xs-3">
                        <input data-params='{"custom[pid]":"0"}' id="c-category1" data-source="/user/mall/oper/area/selectpage" class="form-control selectpage" placeholder="{:__('Category L1')}" type="text">
                    </div>
                    <div class="col-xs-3">
                        <input id="c-category2" data-source="/user/mall/oper/area/selectpage" class="form-control selectpage" placeholder="{:__('Category L2')}" type="text">
                    </div>
                    <div class="col-xs-3">
                        <input id="c-category3" data-source="/user/mall/oper/area/selectpage" class="form-control selectpage" placeholder="{:__('Category L3')}" type="text">
                    </div>
                    <div class="col-xs-3">
                        <input id="c-category4" data-source="/user/mall/oper/area/selectpage" class="form-control selectpage" placeholder="{:__('Category L4')}" type="text">
                    </div>

                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">{:__('Shopaddress')}:</label>
                <div class="col-xs-12 col-sm-8">
                    <input id="c-shopAddress" class="form-control" name="row[shopAddress]" type="text" value="{$apply.shopAddress}">
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">{:__('Shoptel')}:</label>
                <div class="col-xs-12 col-sm-8">
                    <input id="c-shopTel" class="form-control" name="row[shopTel]" type="text" value="{$apply.shopTel}">
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">{:__('Shopkeeper')}:</label>
                <div class="col-xs-12 col-sm-8">
                    <input id="c-shopkeeper" class="form-control" name="row[shopkeeper]" type="text" value="{$apply.shopkeeper}">
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">{:__('Telephone')}:</label>
                <div class="col-xs-12 col-sm-8">
                    <input id="c-telephone" class="form-control" name="row[telephone]" type="text" value="{$apply.telephone}">
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">{:__('Bankusername')}:</label>
                <div class="col-xs-12 col-sm-8">
                    <input id="c-bankUserName" class="form-control" name="row[bankUserName]" type="text" value="{$apply.bankUserName}">
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">{:__('Bankno')}:</label>
                <div class="col-xs-12 col-sm-8">
                    <input id="c-bankNo" class="form-control" name="row[bankNo]" type="text" value="{$apply.bankNo}">
                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">{:__('Bankid')}:</label>
                <div class="col-xs-12 col-sm-8">
                    <select id="c-bankId" class="form-control" name="row[bankId]">
                        {volist name=":config('mall.banks')" id='vo'}
                        <option value='{$key}' {if $apply['bankId']==$key}selected{/if}>{$vo}</option>
                        {/volist}
                    </select>

                </div>
            </div>
            <div class="form-group">
                <label class="control-label col-xs-12 col-sm-2">{:__('Bankareaids')}:</label>
                <div class="col-xs-12 col-sm-8">
                    <input id="c-bankAreaIds" data-rule="required" class="form-control" name="row[bankAreaIds]" type="hidden" value="{$apply.bankAreaIds}">
                    <div class="col-xs-3">
                        <input data-params='{"custom[pid]":"0"}' id="c-bankAreaIds1" data-source="/user/mall/oper/area/selectpage" class="form-control selectpage" placeholder="{:__('Category L1')}" type="text">
                    </div>
                    <div class="col-xs-3">
                        <input id="c-bankAreaIds2" data-source="/user/mall/oper/area/selectpage" class="form-control selectpage" placeholder="{:__('Category L2')}" type="text">
                    </div>
                    <div class="col-xs-3">
                        <input id="c-bankAreaIds3" data-source="/user/mall/oper/area/selectpage" class="form-control selectpage" placeholder="{:__('Category L3')}" type="text">
                    </div>
                    <div class="col-xs-3">
                        <input id="c-bankAreaIds4" data-source="/user/mall/oper/area/selectpage" class="form-control selectpage" placeholder="{:__('Category L4')}" type="text">
                    </div>


                </div>
            </div>
            <div class="form-group layer-footer agreement-bottom">
                <label class="control-label col-xs-12 col-sm-2"></label>
                <div class="col-xs-12 col-sm-8">
                    <button onclick='javascript:location.href="/addons/mall/shop/joinstep3"' type="reset" class="btn btn-default btn-embossed">上一步</button>
                    <button onclick='javascript:location.href="/addons/mall/shop/joinstep5"' type="submit" class="btn btn-success btn-embossed disabled">下一步</button>
                </div>
            </div>
      </form>
    </div>
</div>
{/block}


{block name="js"}
{__block__}
{/block}